Winning And Losing States Under Health Care Reform

The above chart (click on chart to enlarge) and the text below are from "Health Care Reform: State Winners And Losers" by Claudia Schur and Marc Berkon on the Health Affairs blog.

Schur and Berkon write:

Determining Winners and Losers

Here’s how our categorization of states works—we classified states as “High Benefit” if the percentage of uninsured is above the national average and as “Low Benefit” if the rate is less than the national average. We then classified states by whether they would be “High Cost”—the top half of the distribution—for each of the financing approaches.

As Exhibit 1 shows, the states most likely to “win” as a result of health care reform are Arkansas, Idaho, Kentucky, North Carolina, Oklahoma, Tennessee, and Utah. All of these states have a relatively high number of uninsured and all are in the bottom half of states in terms of cost under both financing mechanisms. States with a high proportion of uninsured residents also included Arizona, Florida, Nevada, Texas, and Wyoming, but those states are above average in terms of the costs they would bear under each financing option.

Among the states most likely to “lose” are Delaware, Nebraska, and New Hampshire as well as the District of Columbia. Each of these states has a relatively lower-than-average proportion of uninsured residents, and each would fall in the “High Cost” category under either of the financing options. There are four states—Alabama, Indiana, Michigan, and Rhode Island—that while also “Low Benefit” are “Low Cost” as well.

The winner-loser status of the remaining states depends on the financing mechanism used. Under scenarios of taxing higher-income residents, six states (Alaska, California, Colorado, Georgia, New Jersey, and Virginia) would “lose” in terms of cost but would benefit in terms of expanded coverage. Another nine states would be high-cost and low-benefit under either of the financing options. With a tax on high-premium insurance policies, nine states would fare the worst; these states would be both “Low Benefit” and “High Cost” under this scenario.

Read the complete post here.